24/06/2019
THESIS FOR MASTER DEGREE OF CLINICAL PSYCHOLOGY
IRRITABLE BOWEL SYNDROME-ANXIETY CO-MORBIDITY: EPIDEMILOGIC AND PSYCHOLOGIC CHARACTERISTICS
Researcher: DO, Ngoc-Chanh
ABSTRACT
Background: The co-morbidity between irritable bowel syndrome (IBS) and anxiety disorder (AD) is commonly found in outpatient/ family medicine clinics. This chronic condition diminishes the quality of patient’s life and results in high health care costs. The epidemiological and psychological characteristics can affect this co-morbidity.
Aims: This study aims to explore the co-morbidity between IBS and AD in terms of epidemiological and psychological factors.
Methods: This descriptive and case-serie study explores 6 patients from the outpatient department of one public hospital and one private family medicine clinic. IBS patients were diagnosed according to the criteria Rom-III by gastroenterologists or family doctors, who referred them to participate into the study. At first, the patients answered a self-rated HARS questionnaire, then had a 30-45 minute interview directly with the researcher for associated psychological factors. The collected data were qualitatively and quantitatively analyzed by SPSS.
Results: The data highlighted that IBS can be associated with AD. There was no significant statistical difference but possible differences are found: the average age was 38 years, male:female ratio = 1:2 (n = 2, n = 4, respectively), working:jobless ratio = 2:1 (n = 4, n = 2, respectively), high:low education level = 1:2 (n = 2, n = 4, respectively), married:single ratio = 2:1 (n = 4, n = 2, respectively), moderate:low economic status = 1:2 (n = 2, n = 4, respectively). In terms of psychological factors, patients had: (1) personality style characterized by intense emotions, impulsiveness and/or avoidance, and dependence; (2) behavior marked by uncommunicative and negative social interaction, associated with low awareness about disasters, high stress and embarrassment, lost of self-confidence and even excessive modesty while facing difficult situations; (3) coping style distinguished by inefficient adaptability, and immature and fragile defense mechanism; (4) no belief in health and treatment shown by intolerance (do not take medication regularly); and (5) no confidence in family and social support.
Conclusion: This study highlights the co-morbidity between irritable bowel syndrome and anxiety disorder, and opens the need for future research to assess the causative-pathway relationship between these two pathologies.
Keywords: Irritable Bowel Syndrome, Anxiety Disorder, Psychosocial Factors, Vietnam.
